Individual
KAUSHAL J SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
145 HOSPITAL AVE STE 300, DU BOIS, PA 15801-1465
(814) 375-2040
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-2040
(814) 375-7717
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
0101262871
VA
2086S0129X
Vascular Surgery Physician
35.090188
OH
2086S0129X
Vascular Surgery Physician
Primary
MD427835
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720178536
—
VA
05
—
2650180
—
OH
Enumeration date
10/13/2006
Last updated
03/17/2018
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